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The development of the material in this volume began with a realization by the staff at The Cambridge-Somerville Mental Health and Retardation Center (in the Massachusetts cities of Cambridge and Somerville) that an increasing num- ber of people were entering the mental health system with problems related to the very nature of their personalities. A significant number of these people presented issues that had not been identified previously within the spectrum of psychiatric treatment. Such issues as marital discord in- volving impulsive and violent behavior toward spouses or children, drug abuse, alcoholism, brawling, and so forth were increasingly being viewed as symptomatic of disruptions in an individual's emotional makeup. These people usually did not seek treatment; their problems were most often managed by courts and social welfare agencies. In fact, we were not clear as to what constituted the best treatment. The conference on which this book is based was conceived of as an attempt to bring together people of varying back- grounds to discuss in a general, nontechnical fashion the approaches they have tried in working with such people. We attempted to bridge the gap between the many sophisticated theorists who work in this area and the front-line personnel who daily confront these problems. Because of the general scope of the conference, the papers covered a wide range of issues and experiences.